(PS8-B45) Explaining Parents’ Level of Engagement in a Brief Behavioral Parenting Program over Telehealth

Behavioral Parenting Training (BPT) is a well-established treatment for children and adolescents with ADHD, as well as for disruptive behaviors in children. Although BPT is effective, it is rife with issues of caregiver engagement. Researchers of in-person BPT have revealed how some family factors can interfere with engagement, such as parental level of education, income level, family size, and single-caregiver versus multi-caregiver households. Both individual and group formats of BPT are effective, although groups tend to be even more variable in engagement and effectiveness. To better understand why some caregivers are more likely to engage in group BPT than others, we retrospectively reviewed medical chart data between the years 2020 and 2022 for families who were enrolled in a brief BPT telehealth program for their 3-to-7-year-old children at a large children’s hospital. The BPT group featured six 1-hour sessions that included support building, psychoeducation, and both modeling and role-playing of effective parenting strategies. An additional aim of this BPT program was to increase accessibility by offering enrollment on a semi-rolling basis, so caregivers could begin sessions at either the start of the Time-In module, which focused on positive parenting strategies, or at the start of the Time-Out Module, which focused on effective discipline strategies. Due to the retrospective nature of this study, we were unable to collect data on many indicators (e.g., parental education, income level) that have previously predicted engagement to BPT delivered in-person. However, we were able to retrospectively collect data on family size and single-caregiver attendance from medical charts. We hypothesized that fewer sessions would be attended by caregivers with larger family size and among caregivers who attended alone. Given the novelty of our semi-rolling enrollment approach, we additionally sought to explore whether sequencing (i.e., starting with either Time-In or Time-Out) affected engagement to a telehealth BPT program. Of 153 families who were enrolled, 103 of these families attended at least one BPT session, with 5 out of 6 sessions being the median of attended sessions per family. A linear regression was run examining which variables best explained the number of sessions attended. Family size significantly (and inversely) explained caregivers’ level of engagement (t = -1.98, p = 0.05) with fewer sessions attended by caregivers among larger families. Notably, caregivers appeared to engage similarly irrespective of attending alone or with a partner (t = 1.54, p = 0.13) and irrespective of treatment sequencing (t = 0.72, p = 0.47). These findings suggest that BPT clinicians might be able to improve caregiver engagement in group therapy over telehealth if they more directly address how having multiple children can be a barrier to caregivers’ engagement with treatment.